摘要
背景:国内外学者已应用CT或MRI对腰椎管狭窄症患者的椎管面积测量进行了大量研究,但由于个体差异、椎管形态差异以及测量方法、测量平面的不同,目前并没有一个公认的具有较好信度的测量方式,未见CT和MRI测量腰椎管面积的一致性和可重复性的报道。目的:分析腰椎CT三维重建和腰椎MRI测量腰椎管狭窄症患者狭窄腰椎管横截面积的一致性和可重复性,探讨狭窄腰椎管横截面积的最佳影像学测量方法。方法:收集2013年1月至2018年1月于西南医科大学附属医院脊柱外科住院行手术治疗的102例腰椎管狭窄症患者的术前腰椎CT三维重建和腰椎MRI影像资料,由2名脊柱外科主治以上医师分别在腰椎CT三维重建、腰椎MRI图像上3次不同时间测量狭窄椎管面积,取狭窄椎管对应的椎间盘中线且平行于上位椎体下终板平面的椎管面积进行测量。使用配对t检验分析两种方法测量的狭窄腰椎管面积结果的差异,使用Pearson相关分析评价两种方法测量的狭窄腰椎管面积结果的相关性,使用组内相关系数(ICC)和Bland-Altman图分析两种方法测量狭窄腰椎管面积的一致性和可重复性,使用Z检验比较两种方法测量的狭窄腰椎管面积结果在观察者内和观察者间的ICC值大小。实验方案得到西南医科大学附属医院伦理委员会批准(批准号KY2020176)。结果与结论:①腰椎CT三维重建及腰椎MRI测量的狭窄腰椎管面积值分别为(136.28±2.38),(139.98±2.30)mm^(2),两者比较差异有统计学意义(t=-3.96,P<0.001);Pearson相关分析显示两种方法测量的狭窄腰椎管面积结果呈正相关(r=0.950,P<0.001);②腰椎CT三维重建及腰椎MRI测量的狭窄腰椎管面积观察者间及观察者内ICC值分别在0.908-0.937及0.942-0.971之间,腰椎MRI的测量结果在观察者间和观察者内的ICC值皆高于CT三维重建(P<0.05);③Bland-Altman分析显示两种方法测量的狭窄腰椎管面积�
BACKGROUND:The domestic and overseas scholars have conducted a large number of studies on the measurement of spinal canal area in patients with lumbar spinal stenosis by CT and MRI.However,due to differences of individuals,spinal canal morphologys,measurement methods and measurement planes,there is no recognized measurement standard and value for the measurement of lumbar spinal canal area at present.There are few reports to evaluate the consistency and repeatability of CT and MRI in measuring lumbar spinal canal area.OBJECTIVE:To analyze the consistency and repeatability of three-dimensional reconstruction CT and MRI in measuring the cross-sectional area of lumbar spinal stenosis,and to explore the best imaging measurement method for the cross-sectional area of lumbar spinal stenosis.METHODS:The preoperative imaging data of 102 patients with lumbar spinal stenosis who underwent surgical treatment in Department of Spinal surgery,the Affiliated Hospital of Southwest Medical University from January 2013 to January 2018 with three-dimensional reconstruction CT and lumbar MRI were collected.The corresponding spinal canal area of each narrow intervertebral disc on three-dimensional reconstruction CT and lumbar MRI images was measured by two spinal surgeons at three different time points.The spinal canal area corresponding to the midline plane of the narrow intervertebral disc parallel to the lower endplate of the upper vertebral body was selected for measurement.Paired t-test was used to analyze the difference in spinal canal area between the results of the two methods.Pearson correlation analysis was used to evaluate the correlation between the results of spinal canal area between the two methods.Intraclass correlation coefficient and Bland-Altman plot were used to analyze the consistency and repeatability of the two methods in measuring the area of narrow lumbar spinal canal.Z-test was used to compare the ICC values of interobserver and intraobserver in measurement of narrow lumbar spinal canal area by the two metho
作者
田洋
唐超
廖烨晖
唐强
马飞
钟德君
Tian Yang;Tang Chao;Liao Yehui;Tang Qiang;Ma Fei;Zhong Dejun(Department of Orthopedics,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第24期3882-3887,共6页
Chinese Journal of Tissue Engineering Research
基金
西南医科大学基金项目(2018-ZRQN-070),项目负责人:唐超。
关键词
腰椎管狭窄症
椎管面积
测量
CT
MRI
一致性
可重复性
lumbar spinal stenosis
spinal canal area
measurement
CT
MRI
consistency
repeatability
